1. Field of the Invention
This invention relates to a method of cementing a liner onto the face of the glenoid cavity of a scapula and a tool which is used to perform the method.
2. Description of the Related Art
Humeral endoprostheses were introduced for the treatment of fractures of the proximal humerus and arthritis of the shoulder joint in the early 1950s. This operation evolved into a complete shoulder replacement with the addition of a high density polyethylene surface to cover the glenoid cavity which is located on the scapular side of the glenohumeral joint. Firm fixation of the polyethylene to the small glenoid cavity with acrylic cement called Methyl Methacrylate has been a constant problem. The complex mechanics of the shoulder joint accentuate this problem and frequently leads to loosening of the polyethylene liner. This difficulty has led many surgeons simply to return to the early surgery of a humeral endoprostheses and omit the polyethylene liner despite its superior pain relieving qualities.
The method of cementing a liner onto the face of the glenoid cavity of a scapula which includes a glenoid vault, and a coracoid process projecting from the scapula, comprises the steps of: (1) creating an opening in the coracoid process adjacent the outer end thereof which communicates with the medullary canal of the coracoid process; (2) creating an elongated bore in the medullary canal which extends from the opening in the coracoid process to the glenoid vault of the scapula; (3) inserting an elongated, hollow, rigid tube, having distal and proximal ends, through the opening and through the bore so that the distal end thereof is positioned in the glenoid vault; (4) placing the distal end of an elongated sleeve, which is slidably mounted on the tube, into sealing engagement with the outer end of the coracoid process; (5) applying suction to the proximal end of the tube to suction fluid and debris from the glenoid vault outwardly through the tube; (6) positioning cement on the face of the glenoid cavity and forcing cement into the glenoid vault while suction is applied to the tube; and (7) positioning the liner on the face of the glenoid cavity so that the liner is brought into contact with the cement.
The tool for performing the above-described method comprises an elongated, hollow, rigid tube having distal and proximal ends with the distal end of the tube having either an angular portion or a curved portion which has a plurality of openings formed therein. The tube has a length such that the distal end thereof may be positioned in the glenoid vault and so that the proximal end of the tube may be placed in communication with a source of suction. An elongated sleeve member is slidably mounted on the tube and preferably has a sealing gasket at its distal end which may be moved into sealing engagement with the coracoid process around the opening formed therein. A flexible obturator is selectively extended through the tube to clear the tube of debris.
It is therefore a principal object of the invention to provide an improved method of cementing a liner onto the face of the glenoid cavity of a scapula.
A further object of the invention is to provide a tool for use in cementing a liner onto the face of the glenoid cavity of a scapula.
These and other objects will be apparent to those skilled in the art.